Symptoms: Alzheimer’s disease versus frontotemporal dementia (FTD)

Mrs. Rita- I not ta… bath, you go (signaling towards the door to leave)

House Help- Aunty lets go, it’s not good to stay without taking bath 

Mrs. Rita-  No , I sa..(said) no why don’t  you understand , you better go otherwi.. no.. go..

House Help- No aunty, it’s too late… come we will go…

She holds her hands and takes her for bathing. Aunty reacts aggressively to the staff girl. She refuses to let her come close to her or help her with her activities of daily living.

This was one instance from the life Mrs. Rita, who suffers from Frontotemporal Dementia.  While one may have been familiar with Dementia of the Alzheimer’s Type, this typology might not be heard too often about.

Dementia is an umbrella term used for a cluster of symptoms exhibited by a person including loss of memory, difficulties in executive functioning and changes in personality and behavior. It spreads to different domains of functioning, with the deterioration generalizing as it progresses. Alzheimer’s and Fronto Temporal are basically 2 different forms of Dementia that manifest different pathologies. A downfall in the functioning is what one is expected to experience, but the way it progresses as well as first symptom observed in these conditions are different. While medically one may understand how it is developed, living with a person who has this comes with its own set of challenges:

FTD or Frontotemporal Dementia affects the Frontal and Temporal Lobes of brain which are responsible for many of the functions like: reasoning, planning, speech, managing emotions, recognition and perception of auditory stimuli etc. Hence, when it comes to FTD, there are stark changes observed in the behavior pattern and personality of the individual that can make care giving as well as coping with them a difficult process for family members. Some of them are:

• Apathy: i.e. lack of concern, emotions or motivation e.g. the patient doesn’t realize that their act of hitting is hurting someone.
• Compulsions and impulsive behavior: repeatedly opening the main door to check if someone has come home; wanting to go out immediately etc
• Exhibitionism: having clothing issues, sitting in a inappropriate manner etc
• Being suspicious of everyone or even a single person regarding any issue: money, theft, taking away of her loved one
• Being violent: aggressively hitting or scratching the house help or family member

Impairments in short term memory and other cognitive faculties that are affected first in Alzheimer’s Disease like:

• Memory loss: most often it is the short term memory that is affected i.e. they may very well remember the events of past, but may struggle to recall recent events like what they did yesterday or grandchildren’s name etc
• Misplacing: the person forgets and is not able to recall/retrace back e.g. doctor’s appointment, house keys, important documents etc
• Disorientation: to time i.e. date, time, year and place i.e. place of stay, route to home etc
• Repetition: They may often repeat their statements, talk over the same issues over and again; have certain fixed preferences like wearing the same dress everyday etc.
• Challenges in planning: a lady who has been an active home maker all her life, problems with her charting the day, cooking, making financial decisions etc.

Speech problems in terms of understanding and communicating are largely affected in FTD patients, while for Alzheimer’s language deficits may exhibit at a much later stage. Primary Progressive Aphasia is one sub category of FTD that further explains the various types of problems one experiences with respect to language.

Now that we have understood how different these two conditions are, what we need to be clear about is the intervention and management of the condition once the diagnosis is received. Dementia of any form, calls for a comprehensive treatment plan. Medications along with good care are what counts in making sure our loved ones are leading a good quality life.

We at Samvedna Care aim to help seniors live happy, active and independent lives, in the comfort of their home and community through interactive caregiving.

Samvedna Care was established in October 2013 with two complementary goals – firstly to provide quality home care services to seniors with limited mobility and social interaction due to various constraints, and secondly to facilitate stimulating community interaction and participation.

Our Dementia Care services are –